Biomedical subjects

M P Prim

Publications and source records attributed to M P Prim.

At least 37 records · Page 2Linked to original sources

PubMed2001

Vestibular and hearing manifestations of phenytoin toxicity: a retrospective series.

We undertook a study to identify the vestibular and hearing abnormalities associated with phenytoin toxicity. Since October 1977, 23 patients with phenytoin toxicity have been referred to the Department of Otorhinolaryngology by the Department of Neurology for electrooculographic (EOG) evaluation. (There have been no cases of serious phenytoin toxicity seen in our department since August 1989.) In addition to EOG, all patients had undergone otoscopic, audiometric, and neurologic examinations. We found that the most common pathologic findings detected by EOG were abnormalities in pursuit tracking. The most common signs found on clinical exploration were cerebellar dysfunction and facial palsy. EOG findings in patients with phenytoin toxicity are compatible with cerebellar disease.

Adolescent↗

PubMed2000

Sarcomatoid carcinoma of the pyriform sinus with brain and subcutaneous metastases: an unusual metastatic spread pattern.

A 63-year-old man presented a polypoid tumor in the laryngeal space involving the right pyriform fossa. The patient underwent a total laryngectomy with bilateral functional neck dissection, and the diagnosis of sarcomatoid carcinoma with malignant fibrous histiocytoma-like stroma was established. The tumor showed an uncommon behavior, with distant metastases to the brain and to the subcutaneous tissue of the abdominal wall. The patient died 1 year after the development of the metastases. Despite its polypoid pattern of growth, sarcomatoid carcinoma of the larynx may behave very aggressively. It is important for clinicians to be aware of the possibility of distant subcutaneous and brain metastases in sarcomatoid tumors of the laryngeal space. If such metastases develop, the prognosis is ominous, with an average life expectancy of 3 months.

Abdominal Neoplasms↗

PubMed2000

Sequelae after nasal septum injuries in children.

OBJECTIVE: To study the results of surgical treatment and sequelae in nasal septum injuries in children. METHODS: Between January 1990 and December 1997, 16 pediatric patients with septal haematoma and/or abscess were treated. Mean age was 5 years (range: 2-14 years). Thirteen were male (81.2%), and three were female (18.8%). In nine cases (56.2%) the disease was a consequence of a minor trauma. Only two children had nasal fracture associated (12.5%). Minimum follow-up after the first visit was 10 months (mean, 3 years). RESULTS: All cases were surgically treated. Minor sequelae were observed in six cases (37.5%), and major ones in ten patients (62.5%). In this latter group, multiple reconstructive procedures were needed. CONCLUSIONS: It is necessary to be aware of the possibility of haematoma and abscess of the nasal septum. Major sequelae can be also expected after cases following minor traumas.

Abscess↗

PubMed2000

Patency and flow of the internal jugular vein after functional neck dissection.

OBJECTIVES: To assess the patency and flow of the internal jugular vein after functional neck dissection. STUDY DESIGN: Prospective study of 54 internal jugular veins in 29 oncologic patients undergoing functional neck dissection between September 1994 and February 1997. METHODS: Patency, presence of thrombosis, characteristics of the vein wall, compressibility, area of the vein both in rest and during Valsalva maneuver, expiratory flow speed, Valsalva flow speed, jugular flow in each side, and total jugular flow were assessed in all veins before and after dissection. All patients were evaluated before and after the procedure by means of duplex Doppler ultrasonography. RESULTS: In no case was there thrombosis before or after the operation. Although total jugular flow decreases during the early postoperative period, it recovers to normal parameters within 3 months after surgery. CONCLUSIONS: According to these results, the patency of the internal jugular vein remains unaltered after functional neck dissection. Ultrasonographically there is no thrombosis after this procedure.

Adult↗

PubMed2000

Postoperative radiotherapy in patients with positive nodes after functional neck dissection.

A study was designed to assess the usefulness of postoperative radiotherapy (RT) in patients with surgically treated laryngeal and hypopharyngeal cancer with histologically proven positive neck nodes. Patients underwent operation between 1984 and 1995, with functional neck dissection (FND) being part of the treatment in all cases. The selection criteria included squamous cell carcinoma, negative margins for the primary tumor, and no previous treatment. For evaluation purposes, patients were divided into 2 groups: surgery alone versus surgery with postoperative RT. Eighty-three patients fulfilled the inclusion criteria and entered the study. All but 1 of the patients were men. The mean age was 58 years (range, 35 to 77 years). A multivariate analysis was used to analyze the prognostic parameters selected by univariate analysis, eg, age, alcohol, tumor location, T and N stages, and presence or absence of extracapsular spread and a desmoplastic pattern. Postoperative RT was not selected by univariate analysis as a prognostic factor, but was included in the multivariate analysis in order to assess its impact on survival and recurrence rates. Using the statistical method of multivariate analysis, we could not find evidence of a benefit to survival or local recurrence rates with postoperative RT in this series. Patients younger than 55 years and those with extracapsular spread had a decreased survival rate and a higher neck recurrence rate, irrespective of the treatment method.

Adult↗

PubMed1999

Von Willebrand disease as cause of unanticipated bleeding following adeno-tonsillectomy.

Von Willebrand disease (vWD) is a frequent autosomal bleeding disorder. We report two unsuspected patients over 6 years of age with this disease operated by tonsillectomy and adenoidectomy (T&A) at our Department. Preoperative hematologic work-up (with activated partial thromboplastic time, prothrombin time, fibrinogen, and platelet count) was normal. Both patients had undergone previous adenoidectomy without complications. In both cases, profuse bleeding was noted in the immediate postoperative period. The therapeutic measures in these situations are discussed and a review of the current literature concerning preoperative hematologic evaluation of T&A is included.

Adenoidectomy↗

PubMed1999

Seasonal patterns of idiopathic facial paralysis: a 16-year study.

The annual frequency of Bell's palsy in 16 consecutive years was investigated in a 465,000-person health area in Madrid, Spain. The annual incidence of Bell's palsy per 100,000 population was found to be 24.1. The male-to-female ratio was 46:54. Seasonal difference in the incidence was noted in our series with fewer cases during summer. According to these results, the illness in Spain seems to have a similar incidence to that in Western countries. In addition to this, Bell's palsy does not have an infectious epidemiologic pattern in our country, but its frequency decreases in warm weather.

Adolescent↗

PubMed1999

Extracapsular spread and desmoplastic pattern in neck lymph nodes: two prognostic factors of laryngeal cancer.

The influence of extracapsular spread (ECS) and a desmoplastic pattern (DP) of metastatic cervical lymph nodes in patients with laryngeal cancer is presented. The study includes 128 patients surgically treated between 1984 and 1992 for squamous cell carcinoma of the larynx with pathologically proven lymph node metastasis. The results were studied from 2 major standpoints: survival and recurrence. The 3-year survival rates were as follows: patients without ECS 73.4%, and with ECS 28.9% (p < .001); patients without a DP 76.9%, and with a DP 43.3% (p < .03). Also, the 3-year recurrence rates in the neck showed significant differences: patients without ECS 10.7%, and with ECS 49.6% (p < .001); patients without a DP 10%, and with a DP 31.6% (p = .1142). Postoperative radiotherapy did not appear to improve the outcome.

Actuarial Analysis↗

PubMed1999

[Postoperative complications of surgery for malignant tumors of the thyroid gland].

In order to assess the main complications following surgical treatment of thyroid neoplasms, a prospective-historical study was made in 145 patients operated between 1985 and 1997. Permanent hypocalcemia was encountered in 3.3% of our cases, and unilateral nerve injury in 2.2%, with 0.7% of fatal complications. The remain complications evaluated include: serohematoma, postoperative bleeding, and wound infection. To sum up, surgery of the thyroid neoplasms is a relatively safety procedure. The incidence of complications is similar to the surgical treatment of the remainder thyroid diseases.

Adolescent↗

PubMed1998

Idiopathic facial paralysis: a randomized, prospective, and controlled study using single-dose prednisone versus acyclovir three times daily.

In a prospective, controlled, and randomized study, we compared the outcome of 101 Bell's palsy patients treated with acyclovir (54 patients) or prednisone (47 patients). The acyclovir dosage was 2400 mg (800 mg three times a day) for 10 days, and prednisone was given as a single daily dose of 1 mg/kg of body weight for 10 days and tapered to 0 over the next 6 days. Minimum follow-up was 3 months in all patients. Patients in the prednisone group had better clinical recovery than those treated with acyclovir. Less degree of neural degeneration was observed in the prednisone group compared with acyclovir patients. The incidence of sequelae was the same in both groups. According to these results, in a 10-day treatment cycle acyclovir given 800 mg three times is not as useful as prednisone given 1 mg/kg of body weight once a day in patients with idiopathic facial nerve paralysis.

Acyclovir↗

PubMed1996

Polymorphous low-grade adenocarcinoma of the tongue.

Primary adenocarcinomas of the oral cavity in minor salivary glands are distinctive lesions which can be subclassified according to their growth patterns or histomorphology. Polymorphous low-grade adenocarcinoma (PLGA) of minor salivary tissue has been recognized as a distinct entity. We report an unusual case of PLGA of the tongue. Only a few previous cases have been reported in the English literature. The treatment is discussed and a review of the current literature concerning this tumour is included.

Adenocarcinoma↗

PubMedDate not supplied

[Vestibular and oculomotor changes in subjects treated with cisplatin].

Cisplatin is an agent used in the treatment of distinct oncologic diseases. We present the electrooculographic (EOG) findings of 6 patients which were seen at our Department under the diagnosis of chronic toxicity for cisplatin and associated vestibular alterations. Mean of age was 45 years. Three subjects were female (50%). The most frequent pathologic finding was ataxic pursuit tracking (100%). Additionally, spontaneous nystagmus, alterations in positional test, and vestibulo-ocular reflex suppression were also found. These results are discussed and the main literature concerning this matter is reviewed.

Adolescent↗

PubMedDate not supplied

[Cost-benefit analysis of the anatomo-pathological study of tonsillectomy specimens in the pediatric population].

To study the cost-benefit of the histological examination of tonsilar samples, we evaluated 567 cases (547 routine and 20 nonroutine cases) of patients under 14 years of age, operated between 1st January 1996 and 30th November 2000. There were 2 routine cases (0.3%), and 6 nonroutine cases (30%) with a diagnosis different to follicular hyperplasia. In this way, our clinical preoperative sensitivity was 75% and specificity 97%. The average cost per case at our Centro to study the tonsilar samples was 30$. We conclude that the histological examination of tonsilar specimens is economically worth only in nonroutine cases, although additional factors (e.g. training of residents of Pathology and the quality control of the institution must be taken into consideration.

Adolescent↗

PubMedDate not supplied

[Speech discrimination through telephone in patients implanted with a Combi 40+].

OBJECTIVE: To assess speech discrimination through line and mobile telephone in cochlear implanted patients. MATERIAL AND METHODS: Eighteen patients implanted with a Combi 40+ went through different speech discrimination tests with a line telephone and three mobile telephones, in quiet and noisy environment. RESULTS: Mean scores for telephonic speech discrimination were 84-92% using CID sentences, 27-58% using bisyllabic words in quiet environment and 15-41% using bisyllabic words in noisy environment. Among the mobile telephones tested, the Siemens M55 reached the best scores. CONCLUSIONS: Telephonic speech discrimination is achieved by a significant number of cochlear implanted patients. Certain mobile telephone models appear to be more advisable for these patients.

Acoustic Stimulation↗

PubMedDate not supplied

Prognostic factors in patients with idiopathic facial paralysis (Bell's palsy): A prospective study.

A prospective study was designed in order to objectively quantify the most important prognostic factors of idiopathic facial paralysis (Bell's palsy). Stepwise logistic regression was applied to data obtained from 178 patients evaluated between April 1994 and September 1995 at La Paz Hospital. Due to statistical requirements, the final number of cases analyzed was 124. In all cases, 28 variables were recorded. The 3 variables selected by the multivariate analysis were: age, maximal stimulation test and treatment employed (prednisone or acyclovir). With these data, a linear discriminant function was obtained with an overall accuracy of 70.8%. The correct prediction rate for complete facial recovery was 82.1% and for absence of complete facial recovery 50.0%.

Acyclovir↗

PubMedDate not supplied

[Blood flow changes in the internal jugular veins after oncological neck surgery without lymph node dissection].

The effect of oncological surgery of the head and neck area without lymph node dissection on the patency and blood flow of the internal jugular veins (IJV) was assessed in a prospective study. Ten IJV of 8 patients who underwent surgery between September 1994 and February 1997 were evaluated. Ultrasound Doppler (UD) of both IJV was performed before and after surgery. Mean age of patients was 56.3 years (range, 38 to 72 years), and all but one were men. There was no case of postoperative thrombosis. No significant differences were found between the preoperative and postoperative measurements. Consequently, oncological surgery of the head and neck area without lymph node dissection did not seem to affect the patency and UD characteristics of the IJV.

Adult↗

PubMedDate not supplied

[Influence of radiotherapy on the permeability of the internal jugular veins after functional neck dissection].

The influence of postoperative radiotherapy (RT) on the patency and blood flow of the internal jugular veins (IJV) after functional neck dissection (FND) was assessed in a prospective study. Doppler ultrasonography of the IJV was performed before and after surgery. Fifty-four FND were evaluated in 29 oncological patients who underwent surgery between September 1994 and February 1997. Twelve IJV received postoperative RT. There were no cases of thrombosis before or after surgery in any case. Blood-flow speed in the right Valsalva maneuver was the only parameter affected in irradiated patients.

Adult↗

PubMedDate not supplied

[Aetiopathogenesis of Bell's idiopathic peripheral facial palsy].

INTRODUCTION: Bell's facial palsy is a common condition with an incidence varying between 11.5 and 40.2 cases per 100,000 persons per year. However, some aspects of its aetiopathogenesis are still not clear. DEVELOPMENT: Over the years four theories have been suggested to explain the disorder: vascular, immunological, compressive and viral. The vascular theory (the oldest) has been ruled out by various studies. Subsequently, the immunological and compressive theories were described almost simultaneously. The former established the mechanisms generating a neural inflammatory response, and the second the morphological basis which made the nerve sensitive to these mechanisms. Both theories suggested, amongst other agents, a virus as the agent triggering the process. Recently a virus of the herpes simplex family has been identified as the cause of the disease. CONCLUSION: At present there is broad general agreement that Bell s facial palsy is caused by reactivation of a latent infected with human herpes simplex virus, localized to the facial nerve.

Animals↗